Talk of forming state associations started in the 1890s. At the time, Grand Lodge banned the formation of associations. Members began to work on the formation of associations that would conform to the statutes and benefit the Order of Elks.

By 1914, there were 23 state associations in existence, although they were illegal. During the 1914 Grand Lodge Convention in Denver, the movement to bring them into the Order gained momentum.

At the Grand Lodge session the following year in Los Angeles, a comprehensive report on state associations was submitted to the delegates. The report recommended that the necessary constitutional revisions be made to allow recognition of state associations.

Delegates approved the changes, and the amendment was then sent to the subordinate Lodges for ratification. Upon acceptance by the subordinate Lodges, state associations became legal.

Since their formation in 1915, Elk state associations major projects have helped children with disabilities. They have sponsored clinics and run hospitals and youth camps. They have awarded scholarships and taken care of youngsters with cerebral palsy.

These charitable expenditures have totaled well over $200 million in 75 years. Annually, these associations now spend more than $26 million on charitable works.

The oldest Elks state associations are from Ohio, formed in 1898; Wisconsin, started in 1902; and Michigan, started in 1904. Today there are 48 state associations, with California and Hawaii forming one association, and Maryland, Delaware and the District of Columbia comprising another.